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BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2020

Open Access 01-12-2020 | Research article

The Reproductive Agency Scale (RAS-17): development and validation in a cross-sectional study of pregnant Qatari and non-Qatari Arab Women

Authors: Kathryn M. Yount, Laurie James-Hawkins, Hanan F. Abdul Rahim

Published in: BMC Pregnancy and Childbirth | Issue 1/2020

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Abstract

Background

Sustainable Development Goal (SDG) 5 prioritizes women’s empowerment and gender equality, alone and as drivers of other SDGs. Efforts to validate universal measures of women’s empowerment have eclipsed efforts to develop refined measures in local contexts and lifecycle stages. Measures of women’s empowerment across the reproductive lifecycle remain limited, including in the Arab Middle East.

Methods

In this sequential, mixed-methods study, we developed and validated the Reproductive Agency Scale 17 (RAS-17) in 684 women having a normal pregnancy and receiving prenatal care at Hamad Medical Corporation in Doha, Qatar. Participants varied in age (19–46 years), trimester, gravidity (M3.3[SD2.1], range 1–14), and parity (M2.1[SD1.5], range 0–7). Using qualitative research and questionnaire reviews, we developed 44 pregnancy-specific and non-pregnancy-specific agency items. We performed exploratory then confirmatory factor analyses (EFA/CFA) in random split-half samples and multiple-group CFA to assess measurement invariance of the scale across Qatari (n = 260) and non-Qatari Arab (n = 342) women.

Results

Non-Qatari women agreed more strongly than Qatari women that every woman should have university education, and working outside home benefitted women. Qatari women agreed more strongly than non-Qatari women that a woman should be free to sell her property. Qatari women reported more influence than non-Qatari women in decisions about spending their money (M4.6 versus M4.4), food they can eat (M4.4 versus M4.2), and rest during pregnancy (M4.5 versus M4.2). Qatari and non-Qatari women typically reported going most places with permission if accompanied. A 17-item, three-factor model measuring women’s intrinsic agency or awareness of economic rights (5 items) and instrumental agency in decision-making (5 items) and freedom of movement (7 items) had good fit and was partially invariant across groups.

Conclusions

The RAS-17 is a contextual, multidimensional measure of women’s reproductive agency validated in pregnant Qatari and non-Qatari Arab women. This scale integrates pregnancy-specific and non-pregnancy-specific items in dimensions of intrinsic agency and instrumental agency relevant to Arab women of reproductive age. The RAS-17 may be useful to screen for low reproductive agency as a predictor of maternal and perinatal outcomes. The RAS-17 should be validated in other samples to assess its full applicability across the reproductive life cycle.
Appendix
Available only for authorised users
Footnotes
1
Certain definitions of autonomy may apply poorly in societies where some social relationships are restricted but are valued and enabling amidst structural constraints on women’s actions.
 
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Metadata
Title
The Reproductive Agency Scale (RAS-17): development and validation in a cross-sectional study of pregnant Qatari and non-Qatari Arab Women
Authors
Kathryn M. Yount
Laurie James-Hawkins
Hanan F. Abdul Rahim
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2020
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-020-03205-2

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